Healthcare Provider Details

I. General information

NPI: 1548464084
Provider Name (Legal Business Name): SOLDREA L ROBERTS MD, MBA, FACOG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SOLDREA L THOMPSON M.D.

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 ARLEY WAY STE 101
BLUFFTON SC
29910-4301
US

IV. Provider business mailing address

5 BURCKMYER DR
BEAUFORT SC
29907-1709
US

V. Phone/Fax

Practice location:
  • Phone: 843-522-7820
  • Fax: 843-522-7821
Mailing address:
  • Phone: 843-476-2834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036118542
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0361185642
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35.120101
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number57007666
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number51675
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: